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Published in: BMC Neurology 1/2024

Open Access 01-12-2024 | Chronic Lymphocytic Leukemia | Case Report

Progressive multifocal leukoencephalopathy in a patient with B-cell chronic lymphocytic leukemia after COVID-19 vaccination, complicated with COVID-19 and mucormycosis: a case report

Authors: Hamed Amirifard, Mojtaba Shahbazi, Ghasem Farahmand, Zahra Ranjbar, Maryam Kaeedi, Sanaz Heydari Havadaragh

Published in: BMC Neurology | Issue 1/2024

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Abstract

Background

Progressive multifocal leukoencephalopathy (PML) is a rare and fatal opportunistic viral demyelinating infectious disease of the central nervous system (CNS). There are various clinical presenting symptoms for the disease.

Case presentation

This paper presents a clinical case of PML in a patient with B-Chronic lymphocytic leukemia (B-CLL), previously treated with Chlorambucil, later complicated later with COVID-19 and mucormycosis.

Conclusion

PML can develop in the setting of cellular immune dysfunction. Late diagnosis of this disease based on nonspecific symptoms is common, therefore when we face a neurological complication in a CLL or immunocompromised patient, we should consider PML infection. A remarkable feature of this case is the possible triggering effect of COVID-19 vaccination for emergence of PML as the disease can be asymptomatic or sub-clinical before diagnosis.
Literature
1.
go back to reference KARL-ERIK ASTROM EL, MANCALL, AND J. EDWARD P. RICHARDSON, Multifocal Leuko-Encephalopathy: A Hitherto Unrecognized Complication Of Chronic Lymphatic Leukemia And Hodgkin’s Disease 1958. KARL-ERIK ASTROM EL, MANCALL, AND J. EDWARD P. RICHARDSON, Multifocal Leuko-Encephalopathy: A Hitherto Unrecognized Complication Of Chronic Lymphatic Leukemia And Hodgkin’s Disease 1958.
2.
go back to reference Arseni C, Nereanţiu F. Progressive Multifocal Leukoencephalopathy Eur Neurol. 1971;5(5):270–80.PubMed Arseni C, Nereanţiu F. Progressive Multifocal Leukoencephalopathy Eur Neurol. 1971;5(5):270–80.PubMed
4.
go back to reference Mansoor S, et al. Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): a case report from Ireland with review of literature, clinical pitfalls and future direction. Egypt J Neurol Psychiatr Neurosurg. 2021;57(1):7.CrossRefPubMedPubMedCentral Mansoor S, et al. Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): a case report from Ireland with review of literature, clinical pitfalls and future direction. Egypt J Neurol Psychiatr Neurosurg. 2021;57(1):7.CrossRefPubMedPubMedCentral
5.
go back to reference Kartau M, et al. Progressive Multifocal Leukoencephalopathy: current insights. Degener Neurol Neuromuscul Dis. 2019;9:109–21.PubMedPubMedCentral Kartau M, et al. Progressive Multifocal Leukoencephalopathy: current insights. Degener Neurol Neuromuscul Dis. 2019;9:109–21.PubMedPubMedCentral
6.
go back to reference Anand P et al. Progressive multifocal leukoencephalopathy: a 25-year retrospective cohort study. Neurol Neuroimmunol Neuroinflamm, 2019. 6(6). Anand P et al. Progressive multifocal leukoencephalopathy: a 25-year retrospective cohort study. Neurol Neuroimmunol Neuroinflamm, 2019. 6(6).
7.
go back to reference D’Souza A, et al. Progressive multifocal leukoencephalopathy in chronic lymphocytic leukemia: a report of three cases and review of the literature. Clin Lymphoma Myeloma Leuk. 2010;10(1):E1–9.CrossRefPubMed D’Souza A, et al. Progressive multifocal leukoencephalopathy in chronic lymphocytic leukemia: a report of three cases and review of the literature. Clin Lymphoma Myeloma Leuk. 2010;10(1):E1–9.CrossRefPubMed
8.
go back to reference Amend KL, et al. Incidence of progressive multifocal leukoencephalopathy in patients without HIV. Neurology. 2010;75(15):1326–32.CrossRefPubMed Amend KL, et al. Incidence of progressive multifocal leukoencephalopathy in patients without HIV. Neurology. 2010;75(15):1326–32.CrossRefPubMed
9.
go back to reference Danovska M, et al. Chlorambucil- Induced progressive multifocal leucoencephalopathy - a case report. J Neurol Sci. 2019;405:166.CrossRef Danovska M, et al. Chlorambucil- Induced progressive multifocal leucoencephalopathy - a case report. J Neurol Sci. 2019;405:166.CrossRef
10.
go back to reference Dhakal B, et al. Progressive multifocal leukoencephalopathy in the background of chlorambucil treated chronic lymphocytic leukemia: a case report from Nepal. Ann Med Surg (Lond). 2023;85(10):5167–70.CrossRefPubMed Dhakal B, et al. Progressive multifocal leukoencephalopathy in the background of chlorambucil treated chronic lymphocytic leukemia: a case report from Nepal. Ann Med Surg (Lond). 2023;85(10):5167–70.CrossRefPubMed
12.
go back to reference Zhang Y, Wright C, Flores A. Asymptomatic progressive multifocal leukoencephalopathy: a case report and review of the literature. J Med Case Rep. 2018;12(1):187.CrossRefPubMedPubMedCentral Zhang Y, Wright C, Flores A. Asymptomatic progressive multifocal leukoencephalopathy: a case report and review of the literature. J Med Case Rep. 2018;12(1):187.CrossRefPubMedPubMedCentral
13.
14.
15.
go back to reference Infante MT et al. A case of atypical progressive multifocal encephalopathy mimicking acute ischemic stroke: case report and review of literature. Neuroimmunol Neuroinflammation, 2017. 4(10). Infante MT et al. A case of atypical progressive multifocal encephalopathy mimicking acute ischemic stroke: case report and review of literature. Neuroimmunol Neuroinflammation, 2017. 4(10).
16.
go back to reference Neil EC, DeAngelis LM. Progressive multifocal leukoencephalopathy and hematologic malignancies: a single cancer center retrospective review. Blood Adv. 2017;1(23):2041–5.CrossRefPubMedPubMedCentral Neil EC, DeAngelis LM. Progressive multifocal leukoencephalopathy and hematologic malignancies: a single cancer center retrospective review. Blood Adv. 2017;1(23):2041–5.CrossRefPubMedPubMedCentral
17.
go back to reference Pavlovic D, et al. Progressive multifocal leukoencephalopathy: current treatment options and future perspectives. Ther Adv Neurol Disord. 2015;8(6):255–73.CrossRefPubMedPubMedCentral Pavlovic D, et al. Progressive multifocal leukoencephalopathy: current treatment options and future perspectives. Ther Adv Neurol Disord. 2015;8(6):255–73.CrossRefPubMedPubMedCentral
18.
go back to reference Manouchehri N, Steinman L, Stuve O. Biological significance of Anti-SARS-CoV-2 antibodies: lessons learned from Progressive Multifocal Leukoencephalopathy. Neurol Neuroimmunol Neuroinflamm, 2021. 8(2). Manouchehri N, Steinman L, Stuve O. Biological significance of Anti-SARS-CoV-2 antibodies: lessons learned from Progressive Multifocal Leukoencephalopathy. Neurol Neuroimmunol Neuroinflamm, 2021. 8(2).
19.
20.
go back to reference Kiernan K, MacIver NJ. Viral infection interferes with glucose tolerance. Immunity. 2018;49(1):6–8.CrossRefPubMed Kiernan K, MacIver NJ. Viral infection interferes with glucose tolerance. Immunity. 2018;49(1):6–8.CrossRefPubMed
21.
go back to reference Gerganova A, Assyov Y, Kamenov Z. Stress hyperglycemia, diabetes Mellitus and COVID-19 infection: risk factors, clinical outcomes and post-discharge implications. Front Clin Diabetes Healthc. 2022;3:826006.CrossRefPubMedPubMedCentral Gerganova A, Assyov Y, Kamenov Z. Stress hyperglycemia, diabetes Mellitus and COVID-19 infection: risk factors, clinical outcomes and post-discharge implications. Front Clin Diabetes Healthc. 2022;3:826006.CrossRefPubMedPubMedCentral
Metadata
Title
Progressive multifocal leukoencephalopathy in a patient with B-cell chronic lymphocytic leukemia after COVID-19 vaccination, complicated with COVID-19 and mucormycosis: a case report
Authors
Hamed Amirifard
Mojtaba Shahbazi
Ghasem Farahmand
Zahra Ranjbar
Maryam Kaeedi
Sanaz Heydari Havadaragh
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2024
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-024-03650-y

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